Cerebral Ischemia

Abstract

The current interest in the surgical management of extracranial cerebral vascular disease is largely concerned with occlusive lesions of the cervical portion of the carotid arteries. It is becoming apparent, however, that occlusion of the innominate and subclavian arteries may also produce signs and symptoms of cerebral vascular insufficiency and that surgical removal of obstructions in these vessels may be an effective form of treatment.^1-3 It is the purpose of this report to present the clinical manifestations and the radiologic and surgical aspects of this form of cerebral vascular disease. In addition, the factors influencing the development of retrograde circulation in the vertebral arteries associated with subclavian or innominate stenosis, the so-called subclavian steal,^4,5 will be reviewed. Case Material and Roentgenographic Findings Fourteen patients were studied. All had cerebral ischemia associated with atherosclerotic disease of the subclavian or innominate arteries alone or in combination with other extracranial or